Efficacy and safety of intracorneal allogenic ring segment implantation in keratoconus: 1-year results.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
18
08
2022
accepted:
02
06
2023
revised:
15
05
2023
pmc-release:
01
12
2024
medline:
7
12
2023
pubmed:
17
6
2023
entrez:
16
6
2023
Statut:
ppublish
Résumé
To evaluate the safety and efficacy of corneal allogenic intrastromal ring segments in the management of keratoconus patients. The retrospective, nonrandomized, interventional case series consisted of 65 keratoconic eyes of 49 consecutive patients who had ring segment-shaped corneal allografts (KeraNatural®) implanted in intrastromal tunnels created using a femtosecond laser. The main outcome measures were uncorrected visual acuity (UCVA), corrected distant visual acuity (CDVA), refraction, keratometry, and pachymetry. Computed tomography scans of the corneal surfaces were also performed preoperatively as well as 3, 6 and 12 months postoperatively. Mean age was 29.5 ± 7.3 years (median 29, range: 20-52 years). The mean UCVA improved from 0.91 ± 0.50 logMAR preoperatively to 0.40 ± 0.24 logMAR postoperatively at 6 month follow-up (p < 0.01) and the mean CDVA improved from 0.87 ± 0.20 logMAR preoperatively to 0.27 ± 0.06 logMAR postoperatively (p < 0.01). The mean spherical equivalent improved from -8.82 ± 4.57 to -3.45 ± 4.81D (p < 0.01). Average Keratometry decreased from 49.23 ± 5.22 preoperatively to 45.63 ± 4.89 D postoperatively (p < 0.01). Mean anterior and posterior maximum elevation were also decreased significantly (p < 0.01). In one patient, dislocation of the graft towards the tunnel incision site and dehiscense at the tunnel entrance were observed in the first week of the operation. Yellow-white deposits were observed in the segment tunnels in five cases after 6 months. This study demonstrated that implantation of corneal allograft ring segments is a viable alternative treatment for keratoconus with safety and good visual results.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the safety and efficacy of corneal allogenic intrastromal ring segments in the management of keratoconus patients.
METHODS
METHODS
The retrospective, nonrandomized, interventional case series consisted of 65 keratoconic eyes of 49 consecutive patients who had ring segment-shaped corneal allografts (KeraNatural®) implanted in intrastromal tunnels created using a femtosecond laser. The main outcome measures were uncorrected visual acuity (UCVA), corrected distant visual acuity (CDVA), refraction, keratometry, and pachymetry. Computed tomography scans of the corneal surfaces were also performed preoperatively as well as 3, 6 and 12 months postoperatively.
RESULTS
RESULTS
Mean age was 29.5 ± 7.3 years (median 29, range: 20-52 years). The mean UCVA improved from 0.91 ± 0.50 logMAR preoperatively to 0.40 ± 0.24 logMAR postoperatively at 6 month follow-up (p < 0.01) and the mean CDVA improved from 0.87 ± 0.20 logMAR preoperatively to 0.27 ± 0.06 logMAR postoperatively (p < 0.01). The mean spherical equivalent improved from -8.82 ± 4.57 to -3.45 ± 4.81D (p < 0.01). Average Keratometry decreased from 49.23 ± 5.22 preoperatively to 45.63 ± 4.89 D postoperatively (p < 0.01). Mean anterior and posterior maximum elevation were also decreased significantly (p < 0.01). In one patient, dislocation of the graft towards the tunnel incision site and dehiscense at the tunnel entrance were observed in the first week of the operation. Yellow-white deposits were observed in the segment tunnels in five cases after 6 months.
CONCLUSION
CONCLUSIONS
This study demonstrated that implantation of corneal allograft ring segments is a viable alternative treatment for keratoconus with safety and good visual results.
Identifiants
pubmed: 37328510
doi: 10.1038/s41433-023-02618-5
pii: 10.1038/s41433-023-02618-5
pmc: PMC10698022
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3807-3812Informations de copyright
© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
Références
Ophthalmology. 2001 Aug;108(8):1409-14
pubmed: 11470691
Cornea. 2013 Apr;32(4):e2-5
pubmed: 22929159
J Cataract Refract Surg. 2008 May;34(5):789-95
pubmed: 18471634
J Cataract Refract Surg. 2000 Oct;26(10):1473-9
pubmed: 11033393
J Cataract Refract Surg. 2000 Aug;26(8):1117-22
pubmed: 11008037
J Cataract Refract Surg. 2019 Feb;45(2):153-158
pubmed: 30509748
J Refract Surg. 2022 Apr;38(4):256-263
pubmed: 35412922
J Cataract Refract Surg. 2006 May;32(5):756-61
pubmed: 16765791
Ophthalmology. 2004 Apr;111(4):747-51
pubmed: 15051208
Acta Ophthalmol. 2011 Feb;89(1):54-7
pubmed: 19681760
J Cataract Refract Surg. 2002 Sep;28(9):1568-74
pubmed: 12231313
Ophthalmology. 2000 Jul;107(7):1328-32
pubmed: 10889107
Refract Corneal Surg. 1991 Jan-Feb;7(1):46-50
pubmed: 2043543
J Cataract Refract Surg. 2010 May;36(5):814-25
pubmed: 20457375
J Refract Surg. 2017 Feb 1;33(2):110-115
pubmed: 28192590
J Refract Surg. 2018 May 1;34(5):296-303
pubmed: 29738584
J Cataract Refract Surg. 2007 Apr;33(4):648-53
pubmed: 17397738
Am J Ophthalmol. 2021 Feb;222:351-358
pubmed: 33011155
Cornea. 2012 Apr;31(4):387-95
pubmed: 22410615
J Cataract Refract Surg. 2007 Nov;33(11):1886-91
pubmed: 17964393
Eur J Ophthalmol. 2022 Dec 4;:11206721221142995
pubmed: 36464653
Cornea. 2006 Jan;25(1):29-33
pubmed: 16331037
Curr Eye Res. 2013 Aug;38(8):843-50
pubmed: 23806046